“Yet it is politics which may, in the end, prove the service's undoing, because political, rather than clinical, priorities are coming to the fore. More and more cases are emerging of the malign effect on patients of highly politicised management.”

“In my encounters as a journalist with the management of the NHS, I have found a secrecy, paranoia and defensiveness which I seldom met in my previous incarnation as a defence correspondent. Great Ormond Street, that world-famous institution with the heart-warming smiley kid logo, has twice given me statements which were provably untrue and which it was forced to retract.

“We have assimilated a quarter of a million extras, literally supernumeraries, within the voluminous tent of the NHS.

Just outside the tent is the sand into which billions of taxpayers' money soaks without trace.

“Identification of these individuals is easy; look at the hospital telephone directory, and note how often the following descriptions occur: coordinator, commissioner, facilitator, compliance, liaison, outreach, project, regulator, controller. All of these staff require computers, salaries, paid holidays and final-year pensions.

“A responsible government must initiate a thorough review of the financial efficiency of the NHS by senior clinicians. The moral responsibility of running the NHS rests with those who know what treatment and care can be provided with the resources determined by ministers. We will accept that responsibility because someone has to lay out in front of society what is being spent in its name.

“To the current annual bill must be added the cost of the Private Finance Initiative, an enormous confidence trick played on the taxpayer, and the pension expectations of the tens of thousands of NHS staff.

“Politicians cannot continue to be economical with the truth. We treat all-comers, from malnourished infants of economic migrants to octogenarians seeking care at the end of a long hard life.

“We do our best, and we need a rapid clear-out of the non-essential bureaucracy which is slowing patient care and diverting funds needed for the care and cure of sick citizens.”

When the first public golf course was opened on the beautiful island ofKau Sai Chauin Hong Kong,drinking water was provided along the course. One player drank so much that he nearly died of water intoxication (result of drinking excessive amounts of plain water which causes a low concentration of sodium in the blood leading to amongst other problems: ‘brain’ swelling---cerebral oedema).Marathon runners are at greater risk than most as reported by theNew England Medical Journal. There have been othernotable casesof water intoxication elsewhere. I remember one of my professors telling us: the body survives dehydration much better than drowning. How right he was, as water intoxication is in a sense a kind of drowning.

This is not delusional thinking nor some election manifesto from some unknown party: it is happening in Wales!!!

“The Welsh Assembly government, where Labour is the senior coalition partner, has stopped Sats in schools, scrapped the private finance initiative, is abandoning the internal market in the NHS, has imposed tough social housing policies, helped set up a network of credit unions and – belatedly – more or less killed new opencast mining.”

“For the past few years a quiet but momentous revolution has been taking place. That this has passed largely unnoticed in England reflects the media's lack of interest in Wales. English progressives know more about the political transformation in Bolivia than the similar shift happening over the border. Perhaps this is just as well. The Welsh have been left to get on with it, and nobody in England cares enough to try to stop them.

“It was Plaid Cymru that led the attempt to impeach Tony Blair over the invasion of Iraq. It opposed the conflict in Afghanistan from the outset. It wants to scrap Trident and cancel the aircraft carrier and Eurofighter contracts. It would break up the banks, ban short selling, tax foreign exchange transactions, raise capital gains tax, raise income tax for the rich while reducing it for the poor. It would set a maximum wage and give workers seats on corporate boards.

“It seeks to renationalise the railways and curb the power of the supermarkets. It wants a living pension for everyone over 80, to raise benefits in line with average earnings and to scrap tuition fees. It would abandon ID cards, stop detaining asylum seekers and shift sentencing away from prison and towards restorative justice.”

Wednesday, April 21, 2010

The First Emperor of China was worried about the influence of books on his subjects and he chose to burn them and bury those that wrote them.

We generally like to think that we live in a more tolerant society and yet we cannot pretend that books or writings do not exert great influence. It is only natural that the more famous you are the more influential you become. Can fame become an excuse to blur the boundary between right and wrong?

I will not pretend to know the answer but a recent play at the National got me thinking.

Could being as famous as W.H. Auden give him the right to urinate into his sink at Christ Church, Oxford? We know pop stars trash hotel rooms regularly.

The greater shock followed: he mistook a BBC journalist to be his rent boy. Rent boy at Christ Church! People seem to be horrified by the sexual behaviours of Presidents and Prime Ministers. Is it any different with the cultural elite?

Can Britten’s interest in boys detract from some of the greatest music by an English composer, or is it so important to reassure us that his interests were never overtly sexual? Britten’s Children: The Telegraph

It was one of the most thought provoking plays I have seen for a while and perhaps because of his fame, The New Statesman had this to say:

“This is so nearly Bennett's coming-out play that one wonders if an opportunity has been missed or a catastrophe avoided. Perhaps he knew that if he really argued what he hints at in The History Boys and now in The Habit of Art - namely that older men having sex with teenage boys is not necessarily wrong - he would be stripped of his listing as part of the national heritage quicker than you could say Daily Mail.”

Sunday, April 18, 2010

The focus of the S.E.C. case, an investment vehicle called Abacus 2007-AC1, was one of 25 such vehicles that Goldman created so the bank and some of its clients could bet against the housing market. Those deals, which were the subject of an article in The New York Times in December, initially protected Goldman from losses when the mortgage market disintegrated and later yielded profits for the bank.

As the Abacus portfolios in the S.E.C. case plunged in value, a prominent hedge fund manager made money from his bets against certain mortgage bonds, while investors lost more than $1 billion.

According to the complaint, Goldman created Abacus 2007-AC1 in February 2007 at the request of John A. Paulson, a prominent hedge fund manager who earned an estimated $3.7 billion in 2007 by correctly wagering that the housing bubble would burst. Mr. Paulson is not named in the suit.

Goldman told investors that the bonds would be chosen by an independent manager. In the case of Abacus 2007-AC1, however, Goldman let Mr. Paulson select mortgage bonds that he believed were most likely to lose value, according to the complaint.

Goldman then sold the package to investors like foreign banks, pension funds and insurance companies, which would profit only if the bonds gained value. The European banks IKB and ABN Amro and other investors lost more than $1 billion in the deal, the commission said.

It was the fall of 2007, financial markets were collapsing, and Wall Street firms were losing massive amounts of money, as if they were trying to give back a decade's worth of profits in a few brutal months. An investor named John Paulson somehow was scoring huge profits.

His winnings were so enormous they seemed unreal, even cartoonish. His firm, Paulson & Co., would make $15 billion in 2007.

Mr. Paulson's personal cut would amount to nearly $4 billion, or more than $10 million a day. That was more than the 2007 earnings of J. K. Rowling, Oprah Winfrey and Tiger Woods put together. At one point in late 2007, a broker called to remind Mr. Paulson of a personal account worth $5 million, an account now so insignificant it had slipped his mind.

Paulson & Co. had bet against about $5 billion of CDOs and made more than $4 billion from these trades—including $500 million from a single transaction—according to the firm’s investors and an employee of the firm. One of the biggest losers, however, wasn’t any investor on the other side. It was the very bank that worked with Paulson on many of the deals: Deutsche Bank. The big bank had failed to sell all of the CDO deals it constructed at Paulson’s behest and was stuck with chunks of toxic mortgages, suffering about $500 million of losses from these customized transactions, according to a senior executive of the German bank.

These were some of Paulson & Co.’s largest scores.

Mr. Paulson bought a $41 million home in early 2008 in Long Island and he lives with his wife and two daughters on the Upper East Side of Manhattan. The New York Times.

Saturday, April 17, 2010

"The Republic needs neither scientists nor chemists; the course of justice can not be delayed." Judge sentencing Lavoisier to the guillotine, 1794.

To me, one of the joys of foreign visits is that of visiting art museums. At the New York’s Metropolitan Museum one of my earliest discoveries was that of a painting called Antoine-Laurent Lavoisier (1743–1794) and His Wife by Jacques-Louis David (French, 1748–1825). It was an unusual painting because of the story behind Lavoisier.

On my first visit to the Met, I bought a newly published book called The Metropolitan Museum of Art, Favorite Paintings by Hyatt Mayor and in it he wrote:

“His lasting achievement was to establish modern chemistry by drawing up the first list of elements and by analyzing the character and function of air and other gases”

“The intimate grandeur of this painting would alone make it one of the greatest portraits of its century, while its human associations surcharge it with a shiver of wonder."

It is comforting to note that the likes of Dr Grumble were only warned not to blog during the run up to the election. How lucky we are, really! Think guillotine! Think Cambodia!

Thursday, April 15, 2010

"In other countries this would be called looting, here it is called the PPP."Boris Johnson: Mayor of London.

"Londoners will also be outraged that the Tube upgrades promised to them are now threatened," said Johnson. The mayor claimed that Tube Lines's co-owners, Ferrovial, the Spanish owner of Heathrow airport, and Bechtel, the US project management specialist, will be paid £400m in management secondment fees by 2017.

Public private partnerships (PPPs) are arrangements typified by joint working between the public and private sector. In the broadest sense, PPPs can cover all types of collaboration across the interface between the public and private sectors to deliver policies, services and infrastructure. Where delivery of public services involves private sector investment in infrastructure, the most common form of PPP is the Private finance initiative

“PFI makes me particularly angry. It is a guaranteed loan to property investors, where high-rate mortgage payments are kept off-balance to reduce the country’s declared debt. In other words, it’s the Enron of the NHS. This is money the NHS has committed to leave frontline healthcare for the next 35 years.”

Wednesday, April 14, 2010

"At the beginning of the wet season (usually October/November), most adult red crabs suddenly begin a spectacular migration from the forest to the coast, to breed and release eggs into the sea. Breeding is usually synchronized island wide. The rains provide moist overcast conditions for crabs to make their long and difficult journey to the sea. The timing of the migration breeding sequence is also linked to the phases of the moon, so that eggs may be released by the female red crabs into the sea precisely at the turn of the high tide during the last quarter of the moon.

"It is thought that this occurs at this time because there is the least difference between high and low tides. The sea level at the base of the cliffs and on the beaches, where the females release their eggs, at this time varies the least for a longer period, and it is therefore safer for the females approaching the water's edge to release their eggs. Sometimes there are earlier and later migrations of smaller numbers of crabs but all migrations retain this same lunar rhythm.

"The main migration commences on the plateau and can last up to 18 days. Masses of crabs gather into broad columns as they move toward the coast, climbing down high inland cliff faces, and over or around all obstacles in their way, following routes used year after year for both downward and return migrations. Movement peaks in the early morning and late afternoons when it is cooler and there is more shade. If caught in open areas, in unshaded heat, the crabs soon lose body water and die."

Monday, April 12, 2010

Adopted Russian boy, 7, returned by US mother on one-way flight to Moscow... alone: Telegraph

“A confused and upset-looking Artem Saveliev arrived unaccompanied in Moscow on a flight from Tennessee via Washington, on Thursday. He had with him a rucksack containing colouring pens, sweets and biscuits, which had been packed for the journey.

“On his arrival, he gave immigration officials a typed note from his adoptive mother, Torry Ann Hansen, a nurse from Shelbyville, Tennessee, explaining in two succinct paragraphs why she no longer wanted a boy she adopted in September last year.”

In a chapter in The Cockroach Catcher called Good Intentions, I wrote:

.......“It is important for our own sanity to assume that government policies in a democratic country have good intentions.”

“Tony Blair set a goal in 2000 for a 50 per cent increase in adoptions, to reduce the time children spent in foster care. In the last round of targets, councils were offered bonuses totaling £36 million for increasing the number and speed of adoptions.

Cash rewards for councils which put up more babies for adoption could be scrapped in a shake-up of government targets.

Campaigners blame the incentives for a sharp rise in adoptions, some of which they claim involve babies taken from their parents for no good reason.

More than 2,000 babies aged under 12 months were taken for adoption last year, almost three times the level of a decade ago.”

The rate for older children adoption actually dropped in that period. That was Tony Blair’s original intention.

“Lord Justice Wall said the failure of social workers in the London borough of Greenwich to support a mother trying to make changes to her life and get back her two children, who are in care, was ''quite shocking''.

The judge said what occurred would do little to dispel the perception of many that social workers were ''arrogant and enthusiastic removers of children from their parents into an unsatisfactory care system - trampling on the rights of parents and children in the process.''

Lord Justice Wall will be sworn in today as the president of the High Court’s Family Division. Jack Straw, the Justice Secretary, originally challenged his appointment. Lord Justice Wall has been an outspoken critic of some government policies, including the funding of family courts.

As part of the government's £375m Quality Protects shake-up of services for children in care, the Children's Social Services framework set local authorities clear targets to improve the safety and wellbeing of children in care. The intention is that vulnerable children will spend less time waiting to be adopted under these new targets.

Government figures reveal the number of children being looked after rose to 55,300 - up 4% on 1998 and 11% on 1995. In some 34,100 of these cases - 2,000 more than the previous year, local authorities were forced to go to court to obtain a care order to protect the child. 44% were under 10 years old.

As expected, these targets influenced behaviours, not always in a desirable way.

Hammersmith and Fulham council, in west London, was paid £500,000 as a reward for placing more than 100 children for adoption in three years. The council is the first to acknowledge publicly a payout under the target scheme. It said that its social workers had "pulled out all the stops" and "cut down on the amount of bureaucracy" to boost the numbers.

The council announced its success in a press release headed "Adoption target met". Its disclosure appeared to contradict the claims of Kevin Brennan, the children's minister, who seemed to deny the existence of adoption targets when he said earlier this year: "The only national adoption targets, which ended in 2006, were on the number of adoptions of children who were already in care and waiting to be placed for adoption, and on the speeding up of this. There was never a financial incentive for local authorities to meet these national targets."

Critics claim that financial incentives encourage social services departments to target children who can easily be placed in adoptive homes, rather than those at the greatest risk. White baby girls with no health problems are in highest demand.

EDM 626:

Babies 'removed to meet targets' - In an Early Day Motion, with cross-party support from 12 MPs, Lib Dem MP John Hemming, warns of "increasing numbers of babies being taken into care, not for the safety of the infant, but because they are easy to get adopted".

Hemming, John

“That this House notes that local authorities and their staff are incentivised to ensure that children are adopted; is concerned about increasing numbers of babies being taken into care, not for the safety of the infant, but because they are easy to get adopted; and calls urgently for effective scrutiny of care proceedings to stop this from happening.”

"......Peggy Hilt wanted to be a good mother. But day after day, she got out of bed feeling like a failure. No matter what she tried, she couldn't connect with Nina, the 2-year old girl she'd adopted from Russia as an infant.

"......Then Hilt did something unthinkable. She grabbed Nina around the neck, shook her and then dropped her to the floor, where she kicked her repeatedly before dragging her up to her room, punching her as they went. 'I had never hit a child before,' she says. 'I felt horrible and promised myself that this would never happen again.' But it was too late for that. Nina woke up with a fever, and then started vomiting. The next day she stopped breathing. By the time the ambulance got the child to the hospital, she was dead."

1,600 children were adopted by Americans last year. Russian children are the third most popular among US citizens seeking to adopt after Chinese and Guatemalans.

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A budding child psychiatrist

About Me

Before my retirement, I practised child psychiatry for 30 years, 25 of which as a consultant and director. After these years of clinical practice, I felt compelled to tell my stories as I have my doubts as to the validity of some of the assertions of the medical world.
I am the author of the book The Cockroach Catcher, which is based on my work as an NHS child psychiatrist. Contact me on: cockroachcatcher at gmail dot com

Eric Kandel, M.D., who was awarded the Nobel Prize in 2000 for discovering molecular mechanisms of memory storage, told the crowd at last ...

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